Organization
KIMBROUGH ACC MILITARY MTF
Active
Parent organization
KIMBROUGH ACC MILITARY MTF
Other names
AHC LETTERKENNY ARMY DEPOT
Organization subpart
Yes
Provider details
NPI number
Legal business name
KIMBROUGH ACC MILITARY MTF
Authorized official
TERRI KIMBROW (UBO MANAGER)
(301) 677-8512
Entity
Organization
Contact information
Practice address
LETTERKENNY ARMY DEPOT, BLDG 332, CHAMBERSBURG, PA 17201
(717) 245-4018
Mailing address
2480 LLEWELLYN AVE, CDR USAMEDDAC MCXR-BD STE 5800, FORT MEADE, MD 20755-7081
(301) 677-8800
Taxonomy
Speciality
Code
Description
License number
State
261QM1100X
Military/U.S. Coast Guard Outpatient Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164507703
PARENT FACILITY NPI
—
Enumeration date
05/16/2007
Last updated
04/01/2015
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